EPISODE 78

Private Consult with Heather!

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Episode Transcript

October 08, 2021

Do you know what happens during a private lactation consultation?

This is Maureen Farrell and Heather O’Neal and this is The Milk Minute. We’re midwives and lactation professionals bringing you the most up-to-date evidence for all things lactation. So you can feel more confident about feeding your baby, body positivity, relationships, and mental health. Plus, we laugh a little or a lot along the way.

 

So join us for another episode.

 

Before we get into today’s episode where I do a lactation consult with our friend Gabby, we’d like to answer a listener question from Zabrina. She’s a good friend of mine from back in the day, and she asked a very good question in the breasts. Okay, Zabrina wants to know if we could tell her where to donate a used breast pump.

She lives locally to us, which is great, but I don’t actually have the perfect answer for you. Yeah this can be really tricky. And the pump manufacturers really don’t have good recycling programs in place yet. Medela has tried to take pumps and recycle them. They do have a program, but you have to pay for shipping and pumps are heavy.

So the shipping does tend to cost money and then people just don’t really want to do it. Right. And we don’t really know what happens to the pumps after they go back to Medela. Yeah. So my suggestions would be first, there are a lot of buy-sell-trade groups on Facebook for breast pumps that I see people all the time giving away pumps just for the cost of shipping.

So you may not know the person that’s going to, but at least it’s going to someone. You could also call a local homeless shelter or a women’s shelter. Like for somebody suffering with domestic violence, sometimes they take stuff like that. Sometimes they don’t, it kind of depends on the facility. And really, I’m not sure where else to look.

It is considered a medical device. So if there’s any kind of restriction on receiving medical device as a donation, they’re going to not take your pump, but it’s worth calling. And you could also ask a local church. I mean, especially if it’s one that takes clothing donations, why not? You know? Yeah, absolutely.

I would say put it on your personal Facebook as well. If you’re comfortable with that and see what’s out there because insurance is okay with providing breast pumps these days, but sometimes it’s nice to have an extra one for emergencies or travel. Not everybody has insurance, so it can really help somebody else out.

So if you fail on the first try to donate, try, try again. Okay. Thanks Zabrina. Well, let’s hop into, I feel really privileged to be able to listen in to a private consult with Heather and I hope you do too, so let’s hop into it. Yeah. Thanks. I’ve never actually heard you do a private consult and you’ve never heard me do a private consult and I bet we do it differently.

Well, maybe next time I’ll do one on the air. Absolutely. All right. Well, let’s get into my conversation with Gabby.

Maureen, did you know that my love language is deluxe size beauty products that I can squirrel away to my bathroom and rub on my body and smell good and feel like a million dollars? Oddly specific, but I actually did. Yeah. It’s a situation at my house and I’m not that ashamed of it. I’m proud of it. And I’m going to tell you today that I support GLOSSYBOX.

Well lucky for you for your next birthday and probably for Christmas too, you’re going to get a beautifully wrapped, lovely little box containing five deluxe sized beauty products delivered directly to your doorstep from me from GLOSSYBOX. Yeah, but how do you know that they’re any good? It’s really going to be filled with five makeup, hair and skin products from top brands.

And it’s different every month, right? Yeah. It’s packaged with love by their in-house beauty experts and delivered to your doorstep every month. Oh my gosh. That just tickles me pink and I’m so excited about it. Well, if you guys at home want to try GLOSSYBOX you can get $10 off a three-month subscription by following the link in our show notes and join me in rubbing on all the creams and smelling all the smells and using all the best hair products. So use the link in our show notes to get your discount at GLOSSYBOX today.

I’m so excited to meet my new patient today and to introduce her to you guys. I don’t really know what’s going on with her yet, but we’re going to get into it and answer all of her questions. But first I wanted to make a quick note and let you know that all patients that are recorded for their consults have agreed to do this voluntarily and have signed very long thorough media release forms.

Okay. Let’s get into it. Hello, everybody. Welcome to one of the Breastfeeding for Busy Moms private consults. I am very excited to be able to share this consult with you all today with my new friend, Gabby, who is part of the Breastfeeding for Busy Moms Facebook group. So Gabby, would you mind introducing us to yourself and your baby, your baby’s name? And then tell me your story.

Gabby: Yeah. Hi everyone. I’m Gabby. I am the first-time mom. My baby girl Kennedy, she just turned one month, a couple of days ago. Currently I am a stay-at-home mom and I’m working on exclusive breastfeeding and it’s been quite a journey so far. So I’m excited to learn more about that and I’m excited to talk with you.

Heather: Awesome. Okay. So what brings you to a consult? What’s been going?

Gabby: Yeah. So the biggest thing for me currently is kind of just knowing when my baby’s had enough, if I’m producing enough. Sometimes she struggles with latching and that’s something that is a newer thing. In the hospital she was great, but the lactation consult at the hospital came in and they said she had an amazing latch, but since then, it’s kind of just declined. So that’s something that I was hoping we could talk about.

Heather: Okay, so a couple of questions. Number one, are you pumping? Is that part of this equation?

Gabby: I am. So I’m working on getting a supply built up and hopefully we can kind of go back and forth between breastfeeding and bottle feeding with breast milk. But as of right now, we’re kind of just pumping.

Heather: Okay. And bless you, Kennedy. I hear you in the background there.

Gabby: She’s being so good right now.

Heather: Well, if at any point in time she starts wiling out, feel free to pop her on the boob and we can stop what we’re doing and focus on getting her on the breast and looking at what that looks like. Okay. Okay. Are your nipples currently intact or do you have any nipple injuries?

Gabby: Currently they’re intact. And that’s something that I was very prepared for. A lot of people kind of tried to prepare me for the different kinds of injuries. And so far I haven’t encountered any.

Heather: Great. Okay. So then tell me what you mean by her latch is getting worse. What’s happening?

Gabby: So she won’t open her mouth fully to get a good, deep latch. She almost like show gets to the nipple and then almost like slurp in, and it’s not the most comfortable. And it, she seems to get frustrated. She doesn’t quite seem to be getting the full amount that she wants.

Heather: Why do you say?

Gabby: Cause she’ll, she’ll de-latch and then she’ll try again and then de-latch and then try again and then kind of come off and mess around a little bit, kind of lose interest and then come back again. So it makes the feeding time a whole lot longer, whereas before we could get a feeding done in 15, 20 minutes, and now it’s like 45. I’m like, okay, we’re just going to take a break and come back and try again later.

Heather: Okay. I have lots to say about that, but first I have more questions. Of course, this is why when people message me on Facebook and they’re like, quick question, and I’m like, nothing’s quick. I always get 30 follow-up questions. Okay. Is her weight stable?

Gabby: Yes. So when she was born, she was 6 lb 15 oz, and then a couple of days later, her first appointment, she went down to 6 lb 8 oz, and by her three-week appointment, the goal was always back up to birth weight. She far exceeded that. She was half a pound heavier than her goal weight. So that was something we were all very excited for.

Heather: Okay. You’re in a good spot. Do you realize that?

Gabby: So far? Yes, so far, I feel very lucky with her breastfeeding in general, but it’s just the first-time mom fears, I think.

Heather: Well, sure. Yeah. I mean, it’s kind of our biological imperative to have babies and then keep them alive. So we tend to have this underlying voice in our heads that’s like, your baby’s going to die. Your baby’s going to die. If you take your finger off the pulse for one second. And that is super super common with first-timers. But when you have thoughts, like, you know, maybe I’m not enough or maybe I’m starving her, you know, the thoughts that we all have.

Do you ever go and do anything about it? Do you go pump to like prove to yourself that you have it? Do you have any behaviors that you’re like that are affecting your life negatively?

Gabby: Yeah. So I do pump to prove to myself that I am supplying enough. And as of right now I typically will pump within an hour after her feeding. And I’ll get anywhere from two ounces to three ounces. And one of my other kind of big fears, if that’s all that I’m producing, then once she starts eating more, then I won’t be able to keep up with her, which is one of the reasons that I’m creating the supply. But that’s kind of the biggest one, or I’m constantly checking, like making sure she’s swallowing enough, making sure, you know, as she’s feeding she’s swallowing rather than, rather than just using me as a pacifier.

Heather: Hmm. Hmm. Okay. Sorry. I take notes during these, so I don’t have to repeat questions.

I’ve never done a consult where I’ve taken less than a page of notes, just so you know. So this is very common. Okay. Her birth. Tell me about her birth a little bit, because anytime I hear of a baby popping on and off, I just want to make sure that we might not have a birth injury that’s gone undiagnosed. Her behavior sounds normal. I just have to make sure. So tell me about her birth. Yeah.

Gabby: We induced at 39 weeks. There was no medical reason to, we just decided that would be best because my husband was away for work and he was guaranteed to be back for the birth if we did it that way, as well as my doctor being out of town the whole week of her delivery.

We chose our doctor specifically for the delivery and not necessarily for any of the prenatal care. So that was kind of like a shock that he wasn’t going to be there. I was in labor for 19 hours with her. She was taking her sweet time to drop and all that. And once she finally did, and once I was 10 centimeters, I was only pushing for 30 minutes.

Before she was born, she cried right away. So there was no, no fear of that. She, as soon as they had her on my chest, she was instantly kind of like searching, trying to find, trying to like suck and that kind of thing. And so after like 15, 20 minutes of having her, we got her latched and she stayed latched for an hour and a half.

Heather: That’s great.

Gabby: Yeah. Before she fell asleep, then after that we did the cluster feeding for quite a while.

Heather: Okay. All right. Well, that all sounds really good. So if you were to tell me that she was a synclitic for a long time or breach, surprise breach, hello surprise, or there were forceps or a vacuum involved, I might look a little bit closer at it, but right now, just to alleviate one fear before we move on, the popping on and off is fine. Okay. It’s annoying as heck, but with stable weight and finishing feeds and you clearly have milk, so she’s clearly transferring the milk that you do have. If her weight is stable, more than stable. Way more than adequate. We can assume that she is doing the pop on and off method because she’s trying to integrate her reflexes.

So babies are born with a lot more neuron connections than we have now, which is why they’re kind of jittery and why they can’t like coordinate themselves to like pick something up for many, many months. And as they explore their environment, using the reflexes that they were born with, they prune out neurons that they don’t need anymore. So they get a little bit more refined, a little bit more refined until finally you have an eight-month-old who can use the pincer grasp and pick up a green bean. You know, and you’re like, oh, look at you at how smart you are. But one of the things that the babies do is they have a suck and swallow reflex.

Okay. And their lips have super super high sensitivity with nerves. So, you know, more so than even their hands at this point, because obviously we want them to eat. So nature was like, ah, I know how to figure this out. I’ll make the mouth super sensitive. So what your baby is doing is messing around and exploring the environment.

And they do that at the breast first because that’s where they feel the most comfortable. And when they are safe and secure, they can calm down enough to explore and grow and developmentally progress, which is awesome. So if you think about it in that sense, when she’s popping on and off, first of all, she’s probably not super hungry at that point in time.

You know, if she’s happy and popping on and off, she’s fine. She might not be super hungry. If she’s pissed off and can’t coordinate herself to do the suck and swallow and latch and all that, then what I would recommend is maybe getting ahead of her a little bit and looking for those super early feeding cues, like the hand to mouth movement, or maybe biting the blanket and maybe trying to latch her prior to her getting mad.

Cause once they’re mad, it’s really hard to latch a pissed off baby. So it’s kind of hard. I mean, you get to know them over, over the course of time and you kind of know like, oh, she’s going to be wanting to eat soon. But in the beginning, it’s really hard. Also a guideline is, and I don’t support feeding on a strict schedule.

I do not. So on demand feeding is great. But you can keep in mind that breast milk digests in about 90 minutes. So if you fed her 90 minutes ago, you’ll be staring at her like, Hmm. Are you going to be hungry soon? You’re looking for those early feeding cues and kind of paying a little bit more attention because you don’t want to miss your window. Does that make sense?

Gabby: Yeah, absolutely.

Heather: Any questions about that?

Gabby: Nope.

Heather: Okay. So next time she’s popping on and off, I want you to look at her and tell her, you’re so silly, but you’re also so smart. Like, thanks for doing that. She’s like, Ooh, let me just throw the spaghetti at the wall. And if it works and I get the boob in my mouth, I’m going to see if I can do it again.

And she’s practice. She’s literally practicing. So that’s a good thing. We want to tell her she’s doing good. She’s chiming in!

Gabby: Yeah. She’s got her own thing to say about that.

Heather: She’s like, thank you. That’s what I’ve been trying to say, Heather, all this time. Okay. So let’s talk about using you as a pacifier. Tons of questions on this all the time.

So. Newborns only have a certain amount of primal needs and their brains are not even close to fully developed. So their brain doubles in size in the first six months of life. And it takes a long time for them to have a conscious thought where it’s like abstract, like they’re going to mess with you. So like at nine months is when we can start seeing these behavioral things where like they can push your buttons on purpose.

You know, that’s like actually a pretty advanced move by the brain to be able to do that. So a newborn does not actually have the capability to have the abstract thought, “I’m going to use her as a pacifier.” They are very primal and black and white. So like, if they want to suck on something, you give them a boob, either for comfort or for food.

Both of them support exactly what the baby needs in that moment. So we do not want to say that this baby is going to be spoiled. You really can’t spoil a newborn. If she’s telling you she needs something, it’s because she literally needs something. It’s not because she’s like not able to self-soothe or won’t be able to learn how to self-sooth later.

She’s just not reached that developmental milestone yet. Does that make sense? Do you feel like she has been messing with you though? Like, do you feel like her responses are appropriate to the situation?

Gabby: Yes, they certainly do seem to be. She’s she’s such a silly baby. Like some of the things she does, I’m just like, you know, you’re pretty smart for her age, but also like, I know, like you’re saying, she’s not fully developed. And so a lot of the things she’s doing appear to be as if she’s messing with me or just being silly.

Heather: You know, when I had my son, my first baby, so he’s eight now. I remember telling my mom, I think he hates me. And she was like, what? And I said, no, seriously. I think he hates me.

And she was like, Heather, he’s a baby. And I was like, no, he’s out to get me. I know it. He was just a terrible sleeper and I just, after enough sleep exhaustion, I was, I seriously thought this child was like his main objective in life was to make sure that I didn’t sleep or serve myself in any way possible.

So if you get to that point, phone a friend, get a full REM cycle of like at least four hours in a row, chug some water and literally go do something for you. Go to target in sweatpants and walk around with a Starbucks and just exist there. You don’t even have to buy anything. Just go by yourself. Can you do that for me?

Gabby: That sounds amazing. And not buying something in Target’s a little impossible, but yeah, that sounds amazing.

Heather: Dude. I’ve never made it out of a Target spending less than 90 bucks.

Gabby: I always end up in the baby section and there’s always something and I’m like, this would make things so much easier and she would look adorable.

Heather: That’s how they get ya. Okay.

*baby cries*

Do you want to go ahead and latch her?

Okay. So tell me what’s happening. Did she try to slurp your nipple in like a spaghetti noodle or what?

Gabby: She did. Yes.

Heather: Okay. So she likes that feeling. So we need to retrain her to not do that. They’re kind of like puppies in a way. So how is the latch now?

Gabby: So she, once she’s figured out that she’s actually hungry and after a couple of times of latching and unlatching and slurping, she almost like she’ll put her mouth around and then kind of inch her way up. And so she’ll get a deeper latch as it goes, but it doesn’t always start out that way.

Heather: So is it feeling pinchy right now?

Gabby: Right now? It’s good.

Heather: Okay, well, just for practice, because this is what I want you to do whenever you do feel that pinchy feeling or you feel like she’s not deep enough. Okay. So take your finger and slip it between her chin and your breast and just pull her chin down, just flick it down.

And what that does is it pops that bottom lip out and flanges it, and then she’s able to take more breast tissue in her mouth so she can compress the nipple against the soft palate of her mouth instead of the hard palate. How does that feel? Does that feel okay?

Gabby: Mmhmm. And she also has a deeper latch with that as well.

Heather: Yay. Okay. So easy. So that’s something that you can actually do. Even if you’re like, eh, the latch is okay, you can just check it because what happens sometimes when we get that oxytocin rush, is we get sleepy and we kind of forget what’s going on and unless it hurts really bad, we don’t pay attention to it.

So you can kind of make it your own personal practice, that after you latch her, you immediately just after she gets it on there, pretty good. Like you want her to actually be latched, stick your finger between the chin and the boob, pull the chin down, and then you can kind of rest easy knowing that she’s got enough in there and that she’s not going to hurt you.

Is her top lip flanged? Awesome. So, one thing I wanted to tell you that you’re doing really well at is her head and her body are perfectly in line and her belly is directly towards your belly. And what I see sometimes is if you don’t have enough support behind her back, so you’re in bed right now, nursing, which is lovely and what you could do, because depending on how long your nursing sessions are, if they take a long time, which is normal, you can grab a pillow.

Put it behind her back and prevent her from rolling out. Because even if she rolls out and as your arm gets tired, like half an inch, she’s going to pull that nipple with her. And then the nipple tends to move out of the mouth a little bit and we get that shallow latch. So just making sure you have all the supports that you need right there next to you and make sure that she’s not going to go anywhere. You get her where you want her and you cement her in there.

Gabby: And going back to her messing with us kind of thing is sometimes when she is latched, kind of when she’s latching and unlatching and just being silly, she’ll pull her head back. And rather than unlatching, like she used to do, she’ll keep a really strong latch. And I’m like, what are you doing? Like, it doesn’t come with you. It stays where it is, but she’ll just keep, she’ll latch on and then pull her head back like she’s trying to take it with her. And that’s something that I’m like, I try to grab her and like keep her closer. But of course I can’t keep her right here all the time.

Heather: So when that happens, is that usually towards the end of the feed?

Gabby: It is.

Heather: Okay, so this is very normal and your baby is a genius because what she’s actually doing is she’s stretching that nipple which tells your body, I’m still nursing and I want more and she’s actually trying to get another let down. So she’s really, she’s really working it. And she’s trying to get that last bit of milk at the back, which is a little bit fattier and it can be a little bit thicker to get out which is fine and normal. But sometimes they need a little extra help from your muscles and she needs that squeeze. So when you do that, nipple stretching, you get a rush of oxytocin, which squeezes the breast muscles, and it kind of helps that milk ejection and helps her out a little bit. She’s like good to the last drop. That’s what she’s doing. So does it hurt when she does that or is it just kind of surprising?

Gabby: It is surprising, but it can hurt on occasion, especially when she does it repeatedly. When she does it repeatedly, I’ll de-latch her and put her on the other side and she’ll nurse for maybe two, three more minutes and then she kind of falls asleep.

Heather: That’s perfect.

Gabby: But she’s just, just so smart.

Heather: But so are you like, did anyone tell you to do that or did you just naturally switch her to the other boob?

Gabby: Well, I naturally switched her to the other boob, mostly because I didn’t want her to keep pulling on like this, even with that a little bit.

Heather: But do you see how perfect that is? Because breastfeeding, I always tell people it’s like a conversation. It’s really the only conversation that you and your baby can have together because you’re still functioning almost as one person during this breastfeeding experience. She needs you; you need her. So when she’s doing stuff like that, it automatically tells your body something and your body responded.

So the more you do that, the more in sync you are. And you’re basically always on the same page. So she pulls your nipple a little bit. It works or it doesn’t, you switch her to the other boob. She gets just that last little bit of milk she needed to go to sleep and that’s it. And it’s amazing. So you did a great job, so good job following your instincts.

Gabby: We’re having a real hard, hard time staying awake right now, too.

Heather: Yeah. Those morning, those morning, late morning, naps are rough, you know.

Gabby: Especially when you didn’t really sleep last night, you know?

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Heather: Yeah. So I wanted to talk about the pumping situation. Okay. How much do you have in your freezer?

Gabby: So right now I probably have, probably close to 60 ounces. So not as much as I would like, but I feel like that’s a good stash for only pumping every once in a while.

Heather: Do you plan on going back to work outside of the home?

Gabby: As of right now, I’m unsure. I was working as a pharmacy technician, but since I quit, the pharmacy has kind of gone under. So going back to that is not an option. So I’m not sure.

Heather: Okay. Okay. So 60 ounces in the freezer. That is more than enough. Okay. So you say you’re pumping occasionally. When does that look like? Like what’s your schedule?

Gabby: So ideally I’d like to pump three times a day, but that doesn’t happen. I typically pump in the morning after her first feeding and I try to pump right before I go to bed, right after her last feeding.

And usually that last pump of the day, I don’t get very much, it’s some, sometimes only an ounce, maybe two. But the first thing for the morning is usually three ounces.

Heather: Okay. And when you do the random third pump in the day in the afternoon, is that usually because you’re nervous about supply?

Gabby: It can be. It’s also, sometimes she will take a really long nap in the evening time or afternoon time. And I’m just like, yeah, I’m sore. Like you haven’t eaten in quite a while. I’m just going to get that for that pump, I usually don’t do a full pump. I’ll do maybe partial pump, just cause I’d never know if she’s going to wake up and eat again or that kind of thing, but

Heather: Okay. Okay, so here’s the deal. So you’re still, you’re only one month out and you’re still in that phase where you tend to have more milk than you need because your body is not sure. So it kind of gives you a little bit more than you need, and then you regulate to what baby needs if you’re feeding on demand.

I will tell you right now, If you continue pumping in the morning and at night and occasionally a third time, there is a very good chance you will end up with an oversupply. So let’s really think about this. I want to give you all the info, then you make your own decision, but we have to be prepared for certain things.

Okay. So has baby received a bottle yet or do you want to introduce a bottle at some point?

Gabby: Yes, we have introduced a bottle. We have introduced a bottle a couple of times, just to see if that would be an option for her right now. That’s not something that we want to do all the time. But she takes a bottle totally fine. When she does she’ll usually take three ounces during a feeding and then just completely fall asleep and be totally satisfied for a long time. But that is something that we want to introduce in the future.

Heather: Okay, so quick side note, grab her arm that’s like on the lower side and tuck it around your breast because that bottom arm tends to get in the way between the body between her body and your body, and it’ll push her out and then she’ll try to take your nipple with her.

That pesky arm, those babies are so used to having their hands up in their face in utero and then it’s almost like trying to unfold a pretzel, trying to breastfeed them.

Gabby: Yes, for sure. It’s easiest to breastfeed her when she’s swaddled, cause that’s the only time that her hands aren’t in her face.

Heather: That’s funny. Okay. So with the pumping. Bottles are fine, obviously, but we want to make sure that we are putting into place something that’s sustainable long-term. Because if you are pumping three times a day now, and you decide later, I don’t really want to pump at all, your boobs are going to be like, sorry, what? Because you gave me all of this, all these signals that said we need to have like tons and tons of milk.

Also. You know, if you have, if you end up with 300 ounces in the freezer, which you will have, if you continue doing this, it’s good in the freezer for like 12 months. 12 months in baby time. Your baby’s like walking, eating Graham crackers by then. And then you’re like, oh no. So that we have people who were like, I thought I needed all this milk.

I put myself through all this pumping and now my baby wants pizza and what do I do with it? So it feels like you need to be in a rush right now, but really the average person only has 10 extra ounces in the freezer at any given moment. Because when baby is eating what’s in the freezer, you’re pumping to replace it.

Does that make sense? So even like someone working outside of the home full-time, you only need as much as baby’s going to eat during the day, cause ideally you’re pumping when you’re away from them. So that morning pump is the one that I think from what I’ve seen with my patients, that one is going to give you the most messaging to your body that says we need more. Because you have the most milk in the morning, which you just told me, like you pumped three ounces in the morning. You only pump one to two ounces at night and that’s normal. You typically start out the day with a lot of milk. And then as your prolactin drops throughout the day, you have less.

Okay, which is fine. And babies do great with that. And the milk changes throughout the day to accommodate that. So which of these pumps works best for you? And do you feel like you want to continue pumping at all?

Gabby: You mean like which time of the day pump works best? I personally, I prefer pumping right before I go to bed. That’s the easiest time. She’s all settled in and it just works out better that way. And I do want to continue pumping, I think. That’s something that, cause I’m, I’m very busy a lot and that’s something that will be very easy in the future to just be able to have that bottle ready. And I don’t have to worry about time of the day or, you know, finding a quiet place for her to feel relaxed enough to, to feed.

Heather: Okay, perfect. So then let’s keep that one at night. And how would you feel about maybe not doing it in the morning? Cause I think you’re still going to have a lot. I think that you’re gonna have plenty.

Gabby: Yeah. That would save us a lot of time. A lot of stress. Cause I mean, with that first pump in the morning, it being the larger pump, I try to try to get that one in usually, but if I have a good supply and if I’m able to just pump at least the one time at night, that would be great.

Heather: Yeah, I that’s probably what I would recommend and that one to two ounces adds up. So, you know, the new recommendation is that you can mix different temperature, milk. Okay. So if you get one ounce, stick it in the fridge and then, you know, if you, do you have a haakaa by the way?

Gabby: Yes I do.

Heather: Do you use it?

Gabby: Yes, it’s amazing. It’s like my favorite thing.

Heather: Yeah. It’s also my favorite thing. Okay. So I would collect whatever you collect in the haakaa and then top it off with the one or two ounces at night and freeze a whole feeding. And then that’s it. You have one feeding a day, that’s seven feedings a week and that’s 365 feedings in a year. That’s a lot, you know, so it might not seem a lot in the day to day, but it really does add up, especially considering it’s extra. And that will prevent you from getting an oversupply cause that haakaa is really only collecting milk passively.

It’s not sending a lot of signals to your body that’s like more and more and more. So I like that plan for you, but I will tell you, you will be experiencing a little bit of discomfort in the morning as you stop. So you, if you need to do it gradually, you can. So gradually for you might look like you pump for five less minutes every day in the morning until you’re comfortable.

And then it will take about three days to down-regulate. So you can expect a little bit of fullness in the morning and possibly a little bit of discomfort until that milk downregulates a little bit. We just don’t want pain. So if you’re in physical pain, please pump a little bit, take a little bit off the top, wear a supportive bra for an hour or two, and then release them.

You know, you don’t want to keep them in a tight supportive bra, like all day long. You’ll want to switch to whatever you normally do. So that’s what it would look like to gradually kind of cut down on that morning feed. Does that make sense?

Gabby: Yeah.

Heather: Okay. Do you have a Ceres Chiller?

Gabby: I do not, no.

Heather: Oh, man, I love those things. You said you were busy, so, and you have the haakaa so I know you’re collecting little bits of milk. The Ceres Chiller is awesome. It’s like one of my favorite things, one of my favorite things for breastfeeding moms. So it’s a very sexy thermos and you can even use it for wine when you’re done breastfeeding, which is fabulous.

But it keeps your milk cold for 24 hours and you can combine all your little bits of milk in it, in the fridge. And that way, if you’re out running around, if you do manage to make it to Target and you want to pump, you can put it in a Ceres Chiller and it’ll even keep it cold in a hot car. So if you, yeah, if your partner accidentally like leaves it on the counter in the middle of the night, you don’t have to murder him in the morning.

Gabby: Right. Because we’ve come close to that a couple of times.

Heather: Oh, and it will not be the last time. That’s okay. But yeah, I love those things. So if you’re busy and you’re like, gosh, I don’t want to haul a cooler around every time I leave the house, that’s like my favorite thing. Cause it can like slide in the side pocket of my North Face backpack.

It’s like very portable. Okay. What other questions do you have? Cause I feel like at this point, I really would like you to be conscious of the fact that if you’re questioning your supply or questioning if you have enough for your particular baby and you find yourself about to go pump to prove it to yourself, please remember me saying that what you pump does not equal what baby can get out because babies are a much better pump than a pump.

So it’s actually a fruitless experiment, and it will only confuse your body and take up your time and sanity. So can you commit to not doing that?

Gabby: Yes. That’s very good to know and like I have lots of people around me that pump or that breastfeed anyways and not a lot that have gone through the pumping experience. And so as far as that goes, I was kind of on my own trying this out and trying to figure it out. So all of this has been very, very helpful and it has eased a lot of worries.

Heather: Well, pumping is a whole situation. Like this is one thing that, it’s a curve ball that we threw nature and nature was like, sorry, what are we doing? We need to have milk on the outside of the body now that’s not in a baby? Okay. So how do we do this? So really we’ve just been trying to play catch up and, you know, we didn’t even have at home pumps for like the general public at home until the mid 90’s.

Like, it’s pretty fricking new that everybody gets a pump. And some people even get a pump and they don’t plan on using a pump and they just stare at it. And they’re like, what am I supposed to do with you? So you’re not alone in that at all. And of course, if you have any questions, you can text me. You got me now, so you can text me if you need anything.

I love random questions. I usually answer within you know, a couple hours, but I always tell people, give me 24 hours to respond, but like everyone else in the world, I’m kind of attached to my device. So you’ll probably hear from me sooner than that. What other questions did you have about pumping or your baby’s behavior or any of that?

Gabby: So as far as pumping equipment goes, the sizing of the, the different parts and that kind of thing. That’s something that I was trying to figure out on my own as well. I know there’s a whole measuring system that you can use and I tried that and I just confused myself. I kind of just went with this system of get different sizes and see which one works, but I still don’t know. Like, do you base it off of, you know, which one you use to get the most milk? Which one you use that’s the most comfortable? Like, what’s an easy way to figure out what sizes to use?

Heather: So what size are you using right now?

Gabby: I’m using a 24.

Heather: Okay. So that’s pretty standard. Are you using a 24 on both nipples? Because nipples can be different sizes.

Gabby: Yes, I am using them on both. I tried a couple of different sizes and the 24 just seemed to be the most comfortable on both.

Heather: Okay. So what I tell people is, first of all, you don’t have a nipple injury and you are able to remove milk consistently with your pump. So everything sounds like it’s functioning fine for comfort, unless you’re telling me that you’re uncomfortable during pumping, but you’re not, right?

Gabby: Right.

Heather: Okay. So what I’m telling people is if you feel like you aren’t getting what you should be getting in your pump or your pumping and you still feel really full and you know, you’re new to it. And you’re like, gosh, I wonder if I have the right size? You can kind of twiddle your nipple a little bit until it’s everted and then you measure just the nipple part that’s sticking out at the base. This is hard if you have nipples that point towards the ground, and sometimes you can either take a rolled-up tea towel and stick it under your boobs to kind of level your boob out a little bit so you have access to that nipple, easier for you. Or you can ask your partner to help you, and they kind of have to get down on their knees and you’re just measuring the base of that everted nipple.

And then you’re going to go to your pump manufacturers website and look at their sizing guidelines. I usually tell people; get the size you measure for and then get the one size up. You don’t really want to go down because you don’t want to accidentally pump with one that’s too small and risk sucking that nipple part in and rubbing it against the side of the flange, because that’s going to hurt.

And it’s going to give you a crack at the base of your nipple, and it’s going to suck. Literally. So you can play with it. You can get the one you measured for and the one size up and then see what feels the best to you and see what empties you the best. And that’s my tip. So, but if you, if you’re doing good with yours, don’t rock the cradle.

Gabby: No, I just wanted to make sure that the method I went with of, this one feels the most comfortable, is the best one.

Heather: Yeah, for sure. And then also, I don’t know where you got your pump from. Did you go through a company or something?

Gabby: My insurance company actually covered this one, but it’s just the pump in style one, so.

Heather: Classic. Okay. So every three ish months, you will want to replace the little membrane, at least the little membrane, but your insurance should cover replacement parts quarterly. Okay. If you know, you’re not pumping like exclusively all day, every day, so you might be able to stretch it out a couple more months than that, but just be aware if you’re pumping and you’re like, oh my gosh, I’m not getting as much as I used to. It might be because you need to change your pump parts and your insurance should cover that.

Gabby: Okay. That’s good to know.

Heather: So many little details, right? Let me see this kid one more time. How cute are you? Oh, this is the best part of my job.

Gabby: I sent my husband a little picture, a picture of her and I’m like, I turned our daughter into a little old lady this morning.

Heather: I love her cardigan. Are you going to be a librarian? I hope so.

Gabby: She’s not quiet enough for that yet.

Heather: Quiet. This is the library. Oh my gosh. Look how sweet she is. If I was there in person, I’d want to kiss your neck. Oh, she just barfed on us. Oh, it came out the nose. Fun fact, babies do not have fully formed sinus cavities and that’s why milk comes out their nose very easily and it’s normal.

Gabby: It’s not a crazy common occurrence, but it does happen. And when it does it’s everywhere.

Heather: Well, she must’ve got stage freight from the Zoom. All right, Gabby. Well, what else can I do for you today?

Gabby: Since we’re on the topic, what is a good amount of time to pump? So I’ve read anywhere from 15 to 20 minutes, but it seems like after maybe 10 minutes, after maybe 10 minutes, I’m not really getting, getting anything.

So is that a good time to stop or.

Heather: Yep. Unless you’re power pumping and trying to upregulate your supply and send your body all kinds of messages that says, I need more milk, which you’re not needing, you pump until you pretty much see it start kind of dribbling. And at that point I do a little breast massage.

I check for any hard areas around the breast and you know, the lobes of milk are like spokes on a wheel. So I go around and I check and I make sure. And if I find a lobe that feels a little bit more full, I’ll try to express that while pumping, maybe dangle a little bit. I was a total dangle pumper. Like I would lean forward just a little bit and let gravity work for me.

Just kind of work that milk out of that duct and then turn it off and move on with my life. Yeah, there’s really no, I, those recommendations are, people get so confused and I hate it because then they’re like, I’m pumping for 20 minutes four times a day and I’m like, oh my God, are you okay? They’re like, I have 7,000 ounces of milk and I don’t know why.

So yeah. So your body is telling you that at about 10 minutes, you’re empty. You’re good. Just double-check.

Gabby: Gotcha. Well, that’s good to know. Like those recommendations, they can be so confusing and so misleading. And so that sounds like I’m just going to do what I think feels right. And if that’s after 10 minutes, I’m going to stop and we’re not going to keep going.

Heather: Perfect. And you know, boobs act independently. So, you know, your left breast might be a little behind your right breast. So your left one might be done and your right one’s not done. Just continue pumping both. This is one of the ways that you can kind of deal with that slacker boob. So, you know, making sure that you’re continuing to do the double pumping and try to get that slacker boob to keep up.

And at least you’re not like removing the messaging from that breast that you’re done. Like no righty over here is still going. So you need to like get back in the game, lefty. So you don’t, don’t feel like you have to remove it one at a time, you know, just keep it on there until the last drop on either boob together is done.

Gabby: Yeah, it’s always funny when that slacker boob, I’m just like, what the heck? I got like a quarter of an ounce and this boob over here. I’m like three ounces. That’s great. Like, it didn’t even look uneven. It’s just all of a sudden.

Heather: I know, but we’re all like that. You know, there’s been a lot of different theories that have been thrown around. Like maybe it’s handedness, like right-handed people have, right dominant breasts. Nope. It’s been debunked. So it’s not that. We don’t really know why, but we do know that breasts act independently of each other and people successfully breastfeed with one breast all the time. So we never worry about the slacker boob.

We alternate the same, whatever. It usually shakes out in the wash.

Gabby: Yeah. And it’s always like some, some weeks, one side’s a slacker boob. And then the next week it’s like they switch. And so that, that’s something I’ve noticed, at least for me anyways. It’s like, it started out initially with my left boob being a slacker boob, and in the last week it’s been my right boob and I’m getting so much from my left.

Heather: Well, that’s it. Do you think it’s because you started feeding her more on the slacker boob and she caught that boob up?

Gabby: It’s possible. I try to rotate her with feedings and that’s always something that I noticed when I go to pumping. One side is less than the other. It’s usually the opposite side that I fed her last on, but it still is like, they switch back and forth.

And so I never know which side I’m going to get more from.

Heather: I know, and it’s so hard to keep track, especially when you’re tired. My dad saw me when I was breastfeeding. I was sitting on the couch and I was so tired and I was trying to remember where I left off and I was feeling my boobs to see which one felt heavier.

And he said, hold on, I’ve got just the thing for you. And he went and he got a set of sticky notes and he took the sticky note off and he put it on my shoulder and he says it’s a post-tit note. Get it? Just rotate it every time you feed. And I was like, very funny. If I was well slept, I would laugh.

Gabby: I love it. That’s hilarious.

Heather: All right.

Gabby: In the very beginning, people were like, yeah, you’ll need a bracelet to know which side you last fed on. And the first two weeks I’m like, I can definitely tell which side I fed on last like this side hurts, this side doesn’t. This side’s huge and this side is not so,

Heather: And you know, that will actually end. So I’m glad you said that because after your milk regulates, cause I’m, don’t think you are yet, you’re only a month in, so it varies for everyone, but somewhere between six and eight weeks, you’re finally regulated to what your baby needs and w whatever pumping you’ve added in will start regulating with that as well.

And you won’t feel full all the time. So I get calls from people around this time. Oh, my gosh. I think my supply is tanked. Like I don’t feel full anymore or I don’t actively leak anymore. And I’m like, it’s all good. You’re just regulated. You’re not supposed to be uncomfortable for your entire breastfeeding journey.

Like eventually your body figures it out and adjusts accordingly. So you’re not literally feeling discomfort all the time. So that’s going to be a normal thing that happens. So don’t freak out.

Gabby: That’s good to know because I probably would.

Heather: It’s okay. You have my number, so you can text me and be like, Heather it’s been eight weeks. I’m freaking out. And I’ll be like, okay, send me a picture. And your baby will be like 16 pounds. And I’ll be like, oh, she’s fine. Oh my gosh. Yes, please always send me baby pictures. It’s like the best part of my job.

Gabby: For sure.

Heather: All right, girl, you got anything else for me?

Gabby: No, I think that’s everything we covered so much.

Heather: Okay. Well just text me if you need me, you have my personal cell phone number now, and I will, I’m sure be talking to you soon because things come up and that’s totally fine.

So the only thing that I will tell you is if two months from now you call me and you’re like, Heather I’m formula feeding, like something terrible happened and you didn’t tell me, I’ll be mad. So please reach out and tell me when you actually have a problem, don’t feel bad to reach out. Okay.

Gabby: Absolutely. Thank you so much.

Heather: All right, I’ll talk to you girls later. Bye bye.

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Okay. Before we get outta here, let’s do an award in the alcove. Today’s award goes to Kait Minihan. Kait just left her baby who’s three months old for four and a half days and was pumping in the airport with her Elvies. She says, thanks Elvies. Pumping for the win! Okay. Well today, Kait, we want to give you the “have pump will travel award.”

I love that. Have Pump, Will Travel. Way to get out there and live your life. And I’m glad you have a support system where you can actually trust the person that you left the baby at home with. So you can go and enjoy your time. You deserve it. Good luck. I hope your travels went really smoothly and I hope reuniting with your baby went just as well.

Yes, absolutely. Send us another pic at [email protected] Bye. Toodles.

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